COVID-19 measures and prisoner self-harm: critical timetrends analysis informing policy to improve individual and institutional resilience (COPE)


Research question

What is the impact of the Covid-19 pandemic, and the resulting protection measures, on prisoner self-harm?


Prisons have reacted to the Covid-19 pandemic by minimising person-to-person contact, meaning the cessation of social visits, education and training programmes, non-essential employment, gym access, and religious association. The social isolation associated with these measures has resulted in concerns about prisoner mental health and exacerbation of the already troubling prison self-harm rates. To mitigate these effects, prisons have adopted a range of measures, such as instigating video call visits or providing additional in-cell activities. Although there are cross-prison policies on the pandemic response, there are likely to be heterogeneous responses at an individual prison level and, thus, anticipated differences in the pandemic effects on self-harm rates. Knowing what factors affect prisoners self-harm, and which promote resilience, is vital if we are to learn from the pandemic and enact policies that help reduce prisoner self-harm now and in the future.


1. Understanding changing self-harm from prisoner/staff perspectives

2. Quantifying changes in prisoner self-harm across the pandemic

3. Identifying whether changes, enacted in response to the pandemic, have affected self-harm rates

4. Identifying characteristics which make prisons resilient (or not) to the pandemic’s effects

5. Gaining greater understanding of self-harm in prisons from the natural experiment afforded by the pandemic


We propose to examine the pandemic’s effects on self-harm among prisoners using three data collection phases. The first is a consultation with the Prisoner Policy Network (PPN), a large network consisting mostly of current prisoners. The PPN will be asked to reflect on how the pandemic, and prison measures, have affected their self-harm/mental health. This will help inform the second data collection phase: a bespoke survey of staff in all 114 adult prisons in England/Wales. Staff will be asked to reflect on their experiences of the pandemic and to answer a brief structured questionnaire to ascertain prison-level changes that may have influenced self-harm during the pandemic. Finally, we shall be provided with routinely collected aggregated quantitative data from prison datasets, for which we have permission and access. This will include monthly self-harm statistics, data on prison demographics and other prison attributes.

As part of Framework Analysis, data from the PPN consultation and the short staff interviews will be thematically grouped. Using the quantitative data, independent predictors of self-harm in prisons will be identified using Poisson models with random effects to account for the longitudinal nature of the data.

The findings from this study will be available from mid 2022.


Study team

University of Manchester: Professor Kathryn Abel and Dr Matthias Pierce (principal investigators); Dr Kerry Gutridge, Dr Louise Robinson, Professor Jenny Shaw

Prison Reform Trust: Paula Harriott

University of Southampton & UK Health Security Agency: Dr Emma Plugge

Patient and Public Involvement

We are working in partnership with the Prison Reform Trust, an independent charity that works with current prisoners and people who have left prison. We also have two team members with personal experience of self-harm in prison. The Prison Reform Trust and our team members are involved in the research design, conduct and public engagement.


This research was funded by the National Institute for Health Research (NIHR) Policy Research Programme [grant reference number NIHR202676]. The views expressed are those of the author(s) and are not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.


Dr Kerry Gutridge